In spite of intensive efforts to reduce the risk of hepatitis B after heart operations, this complication is observed in 40 % or more of the cases. Over a period of three years (1974-1976) we examined 588 patients who had undergone open heart surgery. The following results were found: In 1974 the hepatitis frequency was 2.0 %, while in 1975 and 1976 it was 0.6 % hepatitis B and 0.6 % non-B hepatitis. We believe the reason for this improvement is a more careful selection of blood donors and their continuous control according to the following parameters: regular clinical observation; regular chest x-ray; determination of BSR, hemoglobin and aminotransferases; TPHA test; and search for antibodies. In 1974 hepatitis-B-surface-antigen (HBsAg) was detected by means of reverse hemagglutination tests. Since 1975 a modified radioimmunoassay has been used for this purpose. No donor blood with abnormal results was transfused, except for a very small number of extreme emergencies. The good results demonstrated can only be obtained by following the described program and by strictly avoiding pool preparations.

Among 333 patients followed-up after surgery involving a heart-lung machine between 1975 and 1976 seven (2.1%) fell ill with hepatitis. Only in two of them (0.6%) hepatitis B had occurred, caused by HBs-antigen positive blood which had had to be given for a vital indication without testing beforehand. This low rate of disease must now be considered preventable, as in 1975, the time of the transfusions, blood donor control had not reached present-day perfection due to the short period of use of radioimmuno-assay (RIA). In two patients (0.6%) non-B hepatitis following transfusion cannot be excluded although in one patient use of PPSB may be responsible for the disease. Among the 3 other hepatitis cases no aetiological connection between hepatitis and transfusion could be established on the grounds of the incubation period.